Search results for: rapid response healthcare architecture
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10589

Search results for: rapid response healthcare architecture

9869 Durability and Early-Age Behavior of Sprayed Concrete with an Expansion Admixture

Authors: Kyong-Ku Yun, Kyeo-Re Lee, Kyong Namkung, Seung-Yeon Han, Pan-Gil Choi

Abstract:

Sprayed concrete is a way to spray a concrete using a machinery with high air pressure. There are insufficient studies on the durability and early-age behavior of sprayed concrete using high quality expansion agent. A series of an experiment were executed with 5 varying expansion agent replacement rates, while all the other conditions were kept constant, including cement binder content and water-cement ratio. The tests includes early-age shrinkage test, rapid chloride permeability test, and image analysis of air void structure. The early-age expansion test with the variation of expansion agent show that the expansion strain increases as the ratio of expansion agent increases. The rapid chloride permeability test shows that it decrease as the expansion agent increase. Therefore, expansion agent affects into the rapid chloride permeability in a better way. As expansion agent content increased, spacing factor slightly decreased while specific surface kept relatively stable. As a results, the optimum ratio of expansion agent would be selected between 7 % and 11%.

Keywords: sprayed concrete, durability, early-age behavior, expansion admixture

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9868 Mining Diagnostic Investigation Process

Authors: Sohail Imran, Tariq Mahmood

Abstract:

In complex healthcare diagnostic investigation process, medical practitioners have to focus on ways to standardize their processes to perform high quality care and optimize the time and costs. Process mining techniques can be applied to extract process related knowledge from data without considering causal and dynamic dependencies in business domain and processes. The application of process mining is effective in diagnostic investigation. It is very helpful where a treatment gives no dispositive evidence favoring it. In this paper, we applied process mining to discover important process flow of diagnostic investigation for hepatitis patients. This approach has some benefits which can enhance the quality and efficiency of diagnostic investigation processes.

Keywords: process mining, healthcare, diagnostic investigation process, process flow

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9867 Modified Fuzzy Delphi Method to Incorporate Healthcare Stakeholders’ Perspectives in Selecting Quality Improvement Projects’ Criteria

Authors: Alia Aldarmaki, Ahmad Elshennawy

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There is a global shift in healthcare systems’ emphasizing engaging different stakeholders in selecting quality improvement initiatives and incorporating their preferences to improve the healthcare efficiency and outcomes. Although experts bring scientific knowledge based on the scientific model and their personal experience, other stakeholders can bring new insights and information into the decision-making process. This study attempts to explore the impact of incorporating different stakeholders’ preference in identifying the most significant criteria that should be considered in healthcare for electing the improvement projects. A Framework based on a modified Fuzzy Delphi Method (FDM) was built. In addition to, the subject matter experts, doctors/physicians, nurses, administrators, and managers groups contribute to the selection process. The research identifies potential criteria for evaluating projects in healthcare, then utilizes FDM to capture expertise knowledge. The first round in FDM is intended to validate the identified list of criteria from experts; which includes collecting additional criteria from experts that the literature might have overlooked. When an acceptable level of consensus has been reached, a second round is conducted to obtain experts’ and other related stakeholders’ opinions on the appropriate weight of each criterion’s importance using linguistic variables. FDM analyses eliminate or retain the criteria to produce a final list of the critical criteria to select improvement projects in healthcare. Finally, reliability and validity were investigated using Cronbach’s alpha and factor analysis, respectively. Two case studies were carried out in a public hospital in the United Arab Emirates to test the framework. Both cases demonstrate that even though there were common criteria between the experts and the stakeholders, still stakeholders’ perceptions bring additional critical criteria into the evaluation process, which can impact the outcomes. Experts selected criteria related to strategical and managerial aspects, while the other participants preferred criteria related to social aspects such as health and safety and patients’ satisfaction. The health and safety criterion had the highest important weight in both cases. The analysis showed that Cronbach’s alpha value is 0.977 and all criteria have factor loading greater than 0.3. In conclusion, the inclusion of stakeholders’ perspectives is intended to enhance stakeholders’ engagement, improve transparency throughout the decision process, and take robust decisions.

Keywords: Fuzzy Delphi Method, fuzzy number, healthcare, stakeholders

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9866 Use of WhatsApp Messenger for Optimal Healthcare Operational Communication during the COVID-19 Pandemic

Authors: Josiah O. Carter, Charlotte Hayden, Elizabeth Arthurs

Abstract:

Background: During the COVID-19 pandemic, hospital management policies have changed frequently and rapidly. This has created novel challenges in keeping the workforce abreast of these changes to enable them to deliver safe and effective care. Traditional communication methods, e.g. email, do not keep pace with the rapidly changing environment in the hospital, resulting in inaccurate, irrelevant, or outdated information being communicated, resulting in inefficiencies in patient care. Methods: The creation of a WhatsApp messaging group within the medical division at the Bristol Royal Infirmary has enabled senior clinicians and the hospital management team to update the medical workforce in real-time. It has two primary functions: (1) To enable dissemination of a concise, important operational summary. This comprises information on bed status and infection control procedural changes. It is fed directly from a daily critical incident briefing (2) To facilitate a monthly scheduled question and answer (Q&A) session for junior doctors to clarify issues with clinical directors, rota, and management staff. Additional ad-hoc updates are sent out for time-critical information; otherwise, it mainly functions as a broadcast-only group to prevent important information from being lost amongst other communication. All junior doctors within the medical division were invited to join the group. At present, the group comprises 131 participants, of which 10 are administrative staff (rota coordinators, management staff & clinical directors); the remaining 121 are junior clinicians working within the medical division. An electronic survey via Microsoft forms was sent out to junior doctors via the WhatsApp group and via email to assess its utilisation and effectiveness with the aim of quality improvements. Results: Of the 121 group participants, 19 completed the questionnaire (response rate 15.7%). Of these, 16/19 (84.2%) used it regularly, and 12/19 (63.2%) rated it as the most useful source for reliable updates relating to the hospital response to the COVID-19 pandemic, whereas only 2/19 (10.5%) found the trust intranet and the trust COVID-19 operational email update most useful. Respondents rated the WhatsApp group more useful as an information source (mean score 7.7/10) than as a means of providing feedback to management staff (mean score 6.3/10). Qualitative feedback suggested information around ward closures and changes to COVID cohorting, along with updates on staffing issues, were most useful. Respondents also noted the Q&A sessions were an efficient way of relaying feedback about management decisions but that it would be preferable if these sessions could be delivered more frequently. Discussion: During the current global COVID-19 pandemic, there is an increased need for rapid dissemination of critical information within NHS trusts; this includes communication between junior doctors, managers, and senior clinicians. The versatility of WhatsApp permits a variety of functions allowing for regular updates, the dissemination of time-critical information, and enables conversing and feedback. The project has demonstrated that reserved and well-managed use of a WhatsApp group is a welcome, efficient and practical means of communication between the senior management team and the junior medical workforce.

Keywords: communication, COVID-19, hospital management, WhatsApp

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9865 The Design of Safe Spaces in Healthcare Facilities Vulnerable to Tornado Impact in Central US

Authors: Lucy Ampaw-Asiedu, Terri R. Norton

Abstract:

In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: disaster management, safe spaces, structural design, tornado, vulnerability

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9864 A Comprehensive Study of Camouflaged Object Detection Using Deep Learning

Authors: Khalak Bin Khair, Saqib Jahir, Mohammed Ibrahim, Fahad Bin, Debajyoti Karmaker

Abstract:

Object detection is a computer technology that deals with searching through digital images and videos for occurrences of semantic elements of a particular class. It is associated with image processing and computer vision. On top of object detection, we detect camouflage objects within an image using Deep Learning techniques. Deep learning may be a subset of machine learning that's essentially a three-layer neural network Over 6500 images that possess camouflage properties are gathered from various internet sources and divided into 4 categories to compare the result. Those images are labeled and then trained and tested using vgg16 architecture on the jupyter notebook using the TensorFlow platform. The architecture is further customized using Transfer Learning. Methods for transferring information from one or more of these source tasks to increase learning in a related target task are created through transfer learning. The purpose of this transfer of learning methodologies is to aid in the evolution of machine learning to the point where it is as efficient as human learning.

Keywords: deep learning, transfer learning, TensorFlow, camouflage, object detection, architecture, accuracy, model, VGG16

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9863 Treatment of Non-Small Cell Lung Cancer (NSCLC) With Activating Mutations Considering ctDNA Fluctuations

Authors: Moiseenko F. V., Volkov N. M., Zhabina A. S., Stepanova E. O., Kirillov A. V., Myslik A. V., Artemieva E. V., Agranov I. R., Oganesyan A. P., Egorenkov V. V., Abduloeva N. H., Aleksakhina S. Yu., Ivantsov A. O., Kuligina E. S., Imyanitov E. N., Moiseyenko V. M.

Abstract:

Analysis of ctDNA in patients with NSCLC is an emerging biomarker. Multiple research efforts of quantitative or at least qualitative analysis before and during the first periods of treatment with TKI showed the prognostic value of ctDNA clearance. Still, these important results are not incorporated in clinical standards. We evaluated the role of ctDNA in EGFR-mutated NSCLC receiving first-line TKI. Firstly, we analyzed sequential plasma samples from 30 patients that were collected before intake of the first tablet (at baseline) and at 6, 12, 24, 36, and 48 hours after the “starting point.” EGFR-M+ allele was measured by ddPCR. Afterward, we included sequential qualitative analysis of ctDNA with cobas® EGFR Mutation Test v2 from 99 NSCLC patients before the first dose, after 2 and 4 months of treatment, and on progression. Early response analysis showed the decline of EGFR-M+ level in plasma within the first 48 hours of treatment in 11 subjects. All these patients showed objective tumor response. 10 patients showed either elevation of EGFR-M+ plasma concentration (n = 5) or stable content of circulating EGFR-M+ after the start of the therapy (n = 5); only 3 of these patients achieved an objective response (p = 0.026) when compared to the former group). The rapid decline of plasma EGFR-M+ DNA concentration also predicted for longer PFS (13.7 vs. 11.4 months, p = 0.030). Long-term ctDNA monitoring showed clinically significant heterogeneity of EGFR-mutated NSCLC treated with 1st line TKIs in terms of progression-free and overall survival. Patients without detectable ctDNA at baseline (N = 32) possess the best prognosis on the duration of treatment (PFS: 24.07 [16.8-31.3] and OS: 56.2 [21.8-90.7] months). Those who achieve clearance after two months of TKI (N = 42) have indistinguishably good PFS (19.0 [13.7 – 24.2]). Individuals who retain ctDNA after 2 months (N = 25) have the worst prognosis (PFS: 10.3 [7.0 – 13.5], p = 0.000). 9/25 patients did not develop ctDNA clearance at 4 months with no statistical difference in PFS from those without clearance at 2 months. Prognostic heterogeneity of EGFR-mutated NSCLC should be taken into consideration in planning further clinical trials and optimizing the outcomes of patients.

Keywords: NSCLC, EGFR, targeted therapy, ctDNA, prognosis

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9862 Ground Response Analyses in Budapest Based on Site Investigations and Laboratory Measurements

Authors: Zsolt Szilvágyi, Jakub Panuska, Orsolya Kegyes-Brassai, Ákos Wolf, Péter Tildy, Richard P. Ray

Abstract:

Near-surface loose sediments and local ground conditions in general have a major influence on seismic response of structures. It is a difficult task to model ground behavior in seismic soil-structure-foundation interaction problems, fully account for them in seismic design of structures, or even properly consider them in seismic hazard assessment. In this study, we focused on applying seismic soil investigation methods, used for determining soil stiffness and damping properties, to response analysis used in seismic design. A site in Budapest, Hungary was investigated using Multichannel Analysis of Surface Waves, Seismic Cone Penetration Tests, Bender Elements, Resonant Column and Torsional Shear tests. Our aim was to compare the results of the different test methods and use the resulting soil properties for 1D ground response analysis. Often in practice, there are little-to no data available on dynamic soil properties and estimated parameters are used for design. Therefore, a comparison is made between results based on estimated parameters and those based on detailed investigations. Ground response results are also compared to Eurocode 8 design spectra.

Keywords: MASW, resonant column test, SCPT, site response analysis, torsional shear test

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9861 Development of a Diagnostic Device to Predict Clinically Significant Inflammation Associated with Cardiac Surgery

Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

Abstract:

Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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9860 Nimbus Radiance Gate Project: Media Architecture in Sacred Space

Authors: Jorge Duarte de Sá

Abstract:

The project presented in this investigation is part of the multidisciplinary field of Architecture and explores an experience in media architecture, integrated in Arts, Science and Technology. The objective of this work is to create a visual experience comprehending Architecture, Media and Art. It is intended to specifically explore the sacred spaces that are losing social, cultural or religious dynamics and insert new Media technologies to create a new generate momentum, testing tools, techniques and methods of implementation. Given an architectural project methodology, it seems essential that 'the location' should be the starting point for the development of this technological apparatus: the church of Santa Clara in Santarém, Portugal emerged as an experimental space for apparatus, presenting itself as both temple and museum. We also aim to address the concept of rehabilitation through media technologies, directed at interventions that may have an impact on energizing spaces. The idea is emphasized on the rehabilitation of spaces that, one way or another, may gain new dynamics after a media intervention. Thus, we intend to affect the play with a sensitive and spiritual character which endemically, sacred spaces have, by exploring a sensitive aspect of the subject and drawing up new ideas for meditation and spiritual reflection. The work is designed primarily as a visual experience that encompasses the space, the object and the subject. It is a media project supported by a dual structure with two transparent screens operating in a holographic screen which will be projecting two images that complement the translucent overlay film, thus making the merger of two projections. The digitally created content reacts to the presence of observers through infrared cameras, placed strategically. The object revives the memory of the altarpiece as an architectural surface, promoting the expansion of messages through the media technologies.

Keywords: architecture, media, sacred, technology

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9859 Examples from a Traditional Sismo-Resistant Architecture

Authors: Amira Zatir, Abderahmane Mokhtari, Amina Foufa, Sara Zatir

Abstract:

It exists in several regions in the world, of numerous historic monuments, buildings and housing environment, built in traditional ways which survive for earthquakes, even in zones where the seismic risk is particularly raised. These constructions, stemming from vernacular architecture, allow, through their resistances in the time earthquakes, to identify the various sismo-resistant "local" techniques. Through the examples and the experiences presented, the remark which can be made, is that in the traditional built, two major principles in a way opposite, govern the constructions in earthquake-resistant. It is about the very big flexibility, whom answer very light constructions, like the Japanese wooden constructions, Turkish and even Chinese; that of the very big rigidity to which correspond constructions in masonry in particular stone, more or less heavy and massive, which we meet in particular in the Mediterranean Basin, and in the historic sanctuary of Machu Pacchu. In it sensible and well-reflected techniques of construction are added, of which the use of the humble materials such as the earth and the adobe. The ancient communities were able to face the seismic risks, thanks to them know-how reflected in their intelligently designed constructions, testifying of a local seismic culture.

Keywords: earthquake, architecture, traditional, construction, resistance

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9858 Intrusion Detection System Based on Peer to Peer

Authors: Alireza Pour Ebrahimi, Vahid Abasi

Abstract:

Recently by the extension of internet usage, Research on the intrusion detection system takes a significant importance. Many of improvement systems prevent internal and external network attacks by providing security through firewalls and antivirus. In recently years, intrusion detection systems gradually turn from host-based systems and depend on O.S to the distributed systems which are running on multiple O.S. In this work, by considering the diversity of computer networks whit respect to structure, architecture, resource, services, users and also security goals requirement a fully distributed collaborative intrusion detection system based on peer to peer architecture is suggested. in this platform each partner device (matched device) considered as a peer-to-peer network. All transmitted information to network are visible only for device that use security scanning of a source. Experimental results show that the distributed architecture is significantly upgradeable in respect to centralized approach.

Keywords: network, intrusion detection system, peer to peer, internal and external network

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9857 Humanising Digital Healthcare to Build Capacity by Harnessing the Power of Patient Data

Authors: Durhane Wong-Rieger, Kawaldip Sehmi, Nicola Bedlington, Nicole Boice, Tamás Bereczky

Abstract:

Patient-generated health data should be seen as the expression of the experience of patients, including the outcomes reflecting the impact a treatment or service had on their physical health and wellness. We discuss how the healthcare system can reach a place where digital is a determinant of health - where data is generated by patients and is respected and which acknowledges their contribution to science. We explore the biggest barriers facing this. The International Experience Exchange with Patient Organisation’s Position Paper is based on a global patient survey conducted in Q3 2021 that received 304 responses. Results were discussed and validated by the 15 patient experts and supplemented with literature research. Results are a subset of this. Our research showed patient communities want to influence how their data is generated, shared, and used. Our study concludes that a reasonable framework is needed to protect the integrity of patient data and minimise abuse, and build trust. Results also demonstrated a need for patient communities to have more influence and control over how health data is generated, shared, and used. The results clearly highlight that the community feels there is a lack of clear policies on sharing data.

Keywords: digital health, equitable access, humanise healthcare, patient data

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9856 Analyses of Adverse Drug Reactions Reported of Hospital in Taiwan

Authors: Yu-Hong Lin

Abstract:

Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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9855 Study of the Responding Time for Low Permeability Reservoirs

Authors: G. Lei, P. C. Dong, X. Q. Cen, S. Y. Mo

Abstract:

One of the most significant parameters, describing the effect of water flooding in porous media, is flood-response time, and it is an important index in oilfield development. The responding time in low permeability reservoir is usually calculated by the method of stable state successive substitution neglecting the effect of medium deformation. Numerous studies show that the media deformation has an important impact on the development for low permeability reservoirs and can not be neglected. On the base of streamline tube model, we developed a method to interpret responding time with medium deformation factor. The results show that: the media deformation factor, threshold pressure gradient and well spacing have a significant effect on the flood response time. The greater the media deformation factor, threshold pressure gradient or well spacing is, the lower the flood response time is. The responding time of different streamlines varies. As the angle with the main streamline increases, the water flooding response time delays as a "parabola" shape.

Keywords: low permeability, flood-response time, threshold pressure gradient, medium deformation

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9854 The Impacts of New Digital Technology Transformation on Singapore Healthcare Sector: Case Study of a Public Hospital in Singapore from a Management Accounting Perspective

Authors: Junqi Zou

Abstract:

As one of the world’s most tech-ready countries, Singapore has initiated the Smart Nation plan to harness the full power and potential of digital technologies to transform the way people live and work, through the more efficient government and business processes, to make the economy more productive. The key evolutions of digital technology transformation in healthcare and the increasing deployment of Internet of Things (IoTs), Big Data, AI/cognitive, Robotic Process Automation (RPA), Electronic Health Record Systems (EHR), Electronic Medical Record Systems (EMR), Warehouse Management System (WMS in the most recent decade have significantly stepped up the move towards an information-driven healthcare ecosystem. The advances in information technology not only bring benefits to patients but also act as a key force in changing management accounting in healthcare sector. The aim of this study is to investigate the impacts of digital technology transformation on Singapore’s healthcare sector from a management accounting perspective. Adopting a Balanced Scorecard (BSC) analysis approach, this paper conducted an exploratory case study of a newly launched Singapore public hospital, which has been recognized as amongst the most digitally advanced healthcare facilities in Asia-Pacific region. Specifically, this study gains insights on how the new technology is changing healthcare organizations’ management accounting from four perspectives under the Balanced Scorecard approach, 1) Financial Perspective, 2) Customer (Patient) Perspective, 3) Internal Processes Perspective, and 4) Learning and Growth Perspective. Based on a thorough review of archival records from the government and public, and the interview reports with the hospital’s CIO, this study finds the improvements from all the four perspectives under the Balanced Scorecard framework as follows: 1) Learning and Growth Perspective: The Government (Ministry of Health) works with the hospital to open up multiple training pathways to health professionals that upgrade and develops new IT skills among the healthcare workforce to support the transformation of healthcare services. 2) Internal Process Perspective: The hospital achieved digital transformation through Project OneCare to integrate clinical, operational, and administrative information systems (e.g., EHR, EMR, WMS, EPIB, RTLS) that enable the seamless flow of data and the implementation of JIT system to help the hospital operate more effectively and efficiently. 3) Customer Perspective: The fully integrated EMR suite enhances the patient’s experiences by achieving the 5 Rights (Right Patient, Right Data, Right Device, Right Entry and Right Time). 4) Financial Perspective: Cost savings are achieved from improved inventory management and effective supply chain management. The use of process automation also results in a reduction of manpower costs and logistics cost. To summarize, these improvements identified under the Balanced Scorecard framework confirm the success of utilizing the integration of advanced ICT to enhance healthcare organization’s customer service, productivity efficiency, and cost savings. Moreover, the Big Data generated from this integrated EMR system can be particularly useful in aiding management control system to optimize decision making and strategic planning. To conclude, the new digital technology transformation has moved the usefulness of management accounting to both financial and non-financial dimensions with new heights in the area of healthcare management.

Keywords: balanced scorecard, digital technology transformation, healthcare ecosystem, integrated information system

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9853 Surgical Site Infections Post Ventriculoperitoneal (VP) Shunting: A Matched Healthcare Cost and Length of Stay Study

Authors: Issa M. Hweidi, Saba W. Al-Ibraheem

Abstract:

This study aimed to assess the increased hospital length of stay and healthcare costs associated with SSIs among ventriculoperitoneal shunting surgery patients in Jordan. This study adopted a retrospective and nested 1:1 matched case-control design. A non-probability convenient sample of 48 VP shunt patients was recruited for the purpose of the study. The targeted groups of the study basically used to cross-match the variables investigated to minimize the risk of confounding. Information was extracted from the text of patients' electronic health records. As compared to the non-SSI group, the SSI group had an extra mean healthcare cost of $13,696.53 (p=0.001) and longer hospital length of stay (22.64 mean additional days). Furthermore, Acinetobacter baumannii and Klebsiella pneumonia were identified as being the most predominant causative agents of SSIs. The results of this study may provide baseline data for national and regional benchmarking to evaluate the quality of care provided to likewise patients. Adherence to infection control strategies and protocols considering new surveillance methods of SSIs is encouraged.

Keywords: ventriculoperitoneal shunt, health care cost, length of stay, neurosurgery, surgical site infections

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9852 Cellular Architecture of Future Wireless Communication Networks

Authors: Mohammad Yahaghifar

Abstract:

Nowadays Wireless system designers have been facing the continuously increasing demand for high data rates and mobility required by new wireless applications. Evolving future communication network generation cellular wireless networks are envisioned to overcome the fundamental challenges of existing cellular networks, for example, higher data rates, excellent end-to-end performance, and user coverage in hot-spots and crowded areas with lower latency,energy consumption and cost per information transfer. In this paper we propose a potential cellular architecture that separates indoor and outdoor scenarios and discuss various promising technologies for future wireless communication systemssystems, such as massive MIMO, energy-efficient communications,cognitive radio networks, and visible light communications and we disscuse about 5G that is next generation of wireless networks.

Keywords: future challenges in networks, cellur architecture, visible light communication, 5G wireless technologies, spatial modulation, massiva mimo, cognitive radio network, green communications

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9851 Mining Scientific Literature to Discover Potential Research Data Sources: An Exploratory Study in the Field of Haemato-Oncology

Authors: A. Anastasiou, K. S. Tingay

Abstract:

Background: Discovering suitable datasets is an important part of health research, particularly for projects working with clinical data from patients organized in cohorts (cohort data), but with the proliferation of so many national and international initiatives, it is becoming increasingly difficult for research teams to locate real world datasets that are most relevant to their project objectives. We present a method for identifying healthcare institutes in the European Union (EU) which may hold haemato-oncology (HO) data. A key enabler of this research was the bibInsight platform, a scientometric data management and analysis system developed by the authors at Swansea University. Method: A PubMed search was conducted using HO clinical terms taken from previous work. The resulting XML file was processed using the bibInsight platform, linking affiliations to the Global Research Identifier Database (GRID). GRID is an international, standardized list of institutions, including the city and country in which the institution exists, as well as a category of the main business type, e.g., Academic, Healthcare, Government, Company. Countries were limited to the 28 current EU members, and institute type to 'Healthcare'. An article was considered valid if at least one author was affiliated with an EU-based healthcare institute. Results: The PubMed search produced 21,310 articles, consisting of 9,885 distinct affiliations with correspondence in GRID. Of these articles, 760 were from EU countries, and 390 of these were healthcare institutes. One affiliation was excluded as being a veterinary hospital. Two EU countries did not have any publications in our analysis dataset. The results were analysed by country and by individual healthcare institute. Networks both within the EU and internationally show institutional collaborations, which may suggest a willingness to share data for research purposes. Geographical mapping can ensure that data has broad population coverage. Collaborations with industry or government may exclude healthcare institutes that may have embargos or additional costs associated with data access. Conclusions: Data reuse is becoming increasingly important both for ensuring the validity of results, and economy of available resources. The ability to identify potential, specific data sources from over twenty thousand articles in less than an hour could assist in improving knowledge of, and access to, data sources. As our method has not yet specified if these healthcare institutes are holding data, or merely publishing on that topic, future work will involve text mining of data-specific concordant terms to identify numbers of participants, demographics, study methodologies, and sub-topics of interest.

Keywords: data reuse, data discovery, data linkage, journal articles, text mining

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9850 Uptake of Hepatitis B Vaccine among Hepatitis C Positive Patients and Their Vaccine Response in Myanmar

Authors: Zaw Z Aung

Abstract:

Background: High-risk groups for hepatitis B infection (HBV) are people who injected drugs (PWID), men who have sex with men (MSM), people living with HIV (PLHIV) and persons with hepatitis C (HCV), etc. HBV/HCV coinfected patients are at increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. To the best of author’s knowledge, there is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response. Methodology: From February 2018 to May 2018, consented participants at or above 18 years who came to the clinic in Mandalay were tested with the anti-HCV rapid test. Those who tested HCV positive (n=168) were further tested with hepatitis B profile and asked about their previous hepatitis B vaccination history and risk factors. Results: Out of 168 HCV positive participants, three were excluded for active HBV infections. The remaining 165 were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), General Population (GP) monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9). Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 63 participants completed third doses of vaccination (PWID=36, GP=13, HIV/HCV=14). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): HIV/HCV (86%, n=12), PWID (44%, n=16), and GP (46%, n=6) Conclusion: Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, HIV/AIDS and hepatitis C treatment centers is desirable. About half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Keywords: Hepatitis B vaccine, Hepatitis C, HIV, Myanmar

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9849 A Posterior Predictive Model-Based Control Chart for Monitoring Healthcare

Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

Abstract:

Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: average run length (ARL), bernoulli cusum (BC) chart, beta binomial posterior predictive (BBPP) distribution, clinical indicator (CI), healthcare organization (HCO), highest posterior density (HPD) interval

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9848 CPU Architecture Based on Static Hardware Scheduler Engine and Multiple Pipeline Registers

Authors: Ionel Zagan, Vasile Gheorghita Gaitan

Abstract:

The development of CPUs and of real-time systems based on them made it possible to use time at increasingly low resolutions. Together with the scheduling methods and algorithms, time organizing has been improved so as to respond positively to the need for optimization and to the way in which the CPU is used. This presentation contains both a detailed theoretical description and the results obtained from research on improving the performances of the nMPRA (Multi Pipeline Register Architecture) processor by implementing specific functions in hardware. The proposed CPU architecture has been developed, simulated and validated by using the FPGA Virtex-7 circuit, via a SoC project. Although the nMPRA processor hardware structure with five pipeline stages is very complex, the present paper presents and analyzes the tests dedicated to the implementation of the CPU and of the memory on-chip for instructions and data. In order to practically implement and test the entire SoC project, various tests have been performed. These tests have been performed in order to verify the drivers for peripherals and the boot module named Bootloader.

Keywords: hardware scheduler, nMPRA processor, real-time systems, scheduling methods

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9847 A Survey of Response Generation of Dialogue Systems

Authors: Yifan Fan, Xudong Luo, Pingping Lin

Abstract:

An essential task in the field of artificial intelligence is to allow computers to interact with people through natural language. Therefore, researches such as virtual assistants and dialogue systems have received widespread attention from industry and academia. The response generation plays a crucial role in dialogue systems, so to push forward the research on this topic, this paper surveys various methods for response generation. We sort out these methods into three categories. First one includes finite state machine methods, framework methods, and instance methods. The second contains full-text indexing methods, ontology methods, vast knowledge base method, and some other methods. The third covers retrieval methods and generative methods. We also discuss some hybrid methods based knowledge and deep learning. We compare their disadvantages and advantages and point out in which ways these studies can be improved further. Our discussion covers some studies published in leading conferences such as IJCAI and AAAI in recent years.

Keywords: deep learning, generative, knowledge, response generation, retrieval

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9846 Response Surface Methodology for Optimum Hardness of TiN on Steel Substrate

Authors: R. Joseph Raviselvan, K. Ramanathan, P. Perumal, M. R. Thansekhar

Abstract:

Hard coatings are widely used in cutting and forming tool industries. Titanium Nitride (TiN) possesses good hardness, strength and corrosion resistant. The coating properties are influenced by many process parameters. The coatings were deposited on steel substrate by changing the process parameters such as substrate temperature, nitrogen flow rate and target power in a D.C planer magnetron sputtering. The structure of coatings were analysed using XRD. The hardness of coatings was found using Micro hardness tester. From the experimental data, a regression model was developed and the optimum response was determined using Response Surface Methodology (RSM).

Keywords: hardness, RSM, sputtering, TiN XRD

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9845 Reservoir Characterization using Comparative Petrophysical Testing Approach Acquired with Facies Architecture Properties Analysis

Authors: Axel Priambodo, Dwiharso Nugroho

Abstract:

Studies conducted to map the reservoir properties based on facies architecture in which to determine the distribution of the petrophysical properties and calculate hydrocarbon reserves in study interval. Facies Architecture analysis begins with stratigraphic correlation that indicates the area is divided into different system tracts. The analysis of distribution patterns and compiling core analysis with facies architecture model show that there are three estuarine facies appear. Formation evaluation begins with shale volume calculation using Asquith-Krygowski and Volan Triangle Method. Proceed to the calculation of the total and effective porosity using the Bateman-Konen and Volan Triangle Method. After getting the value of the porosity calculation was continued to determine the effective water saturation and non-effective by including parameters of water resistivity and resistivity clay. The results of the research show that the Facies Architecture on the field in divided into three main facies which are Estuarine Channel, Estuarine Sand Bar, and Tidal Flat. The petrophysics analysis are done by comparing different methods also shows that the Volan Triangle Method does not give a better result of the Volume Shale than the Gamma Ray Method, but on the other hand, the Volan Triangle Methode is better on calculating porosity compared to the Bateman-Konen Method. The effective porosity distributions are affected by the distribution of the facies. Estuarine Sand Bar has a low porosity number and Estuarine Channel has a higher number of the porosity. The effective water saturation is controlled by structure where on the closure zone the water saturation is lower than the area beneath it. It caused by the hydrocarbon accumulation on the closure zone.

Keywords: petrophysics, geology, petroleum, reservoir

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9844 Architecture of Contemporary Museums Located in the Historic Center of Cracow: One City, One Architect, Three Projects

Authors: A. Brach

Abstract:

The architecture of modern museums in the historical center should refer to a place in a cultural, historical, urban and architectural sense, using adequate and contemporary forms of architecture. The research and architectural analysis of selected museums in Cracow were conducted to illustrate which elements were decisive for the choice of architectural form. The evaluation of selected objects took into the consideration the following aspects: continuation of the historical form, contemporary form referring to the place, the individual-author form omitting the cultural aspect of the place. The presented projects showed the compromise as positive solutions rejecting both the direct imitation or 'historical continuation' as well as an individual form focused on an abstract form. In order to carry out research and confirm the thesis, three designs of Assoc. Prof. Eng. Arch. Krzysztof Ingarden in the historic city of Cracow were selected. Despite being constructed in one city, the neighborhood and cultural contexts of the locations are completely different. The neighborhood of the historical Royal Road and gothic church with unique decorations from the Polish Art Nouveau, artist Stanislaw Wyspianski (Wyspianski Pavilion), the bend of the Vistula hosting the Japanese culture (Museum of Japanese Art and Technology Manggha) and finally the old area of a horse riding school from the Austrian Empire times (Malopolska Garden of Art). All three buildings are dedicated to the culture of Japan, Polish artist Stanislaw Wyspianski, contemporary achievements and the promotion of art at its widest sense. Important fact for this research is that there is one author of all presented projects.

Keywords: adaptation of existing buildings, architecture in cracow, modern architecture, museums located in historic center

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9843 Seismic Soil-Pile Interaction Considering Nonlinear Soil Column Behavior in Saturated and Dry Soil Conditions

Authors: Mohammad Moeini, Mehrdad Ghyabi, Kiarash Mohtasham Dolatshahi

Abstract:

This paper investigates seismic soil-pile interaction using the Beam on Nonlinear Winkler Foundation (BNWF) approach. Three soil types are considered to cover all the possible responses, as well as nonlinear site response analysis using finite element method in OpenSees platform. Excitations at each elevation that are output of the site response analysis are used as the input excitation to the soil pile system implementing multi-support excitation method. Spectral intensities of acceleration show that the extent of the response in sand is more severe than that of clay, in addition, increasing the PGA of ground strong motion will affect the sandy soil more, in comparison with clayey medium, which is an indicator of the sensitivity of soil-pile systems in sandy soil.

Keywords: BNWF method, multi-support excitation, nonlinear site response analysis, seismic soil-pile interaction

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9842 Physical and Morphological Response to Land Reclamation Projects in a Wave-Dominated Bay

Authors: Florian Monetti, Brett Beamsley, Peter McComb, Simon Weppe

Abstract:

Land reclamation from the ocean has considerably increased over past decades to support worldwide rapid urban growth. Reshaping the coastline, however, inevitably affects coastal systems. One of the main challenges for coastal oceanographers is to predict the physical and morphological responses for nearshore systems to man-made changes over multiple time-scales. Fully-coupled numerical models are powerful tools for simulating the wide range of interactions between flow field and bedform morphology. Restricted and inconsistent measurements, combined with limited computational resources, typically make this exercise complex and uncertain. In the present study, we investigate the impact of proposed land reclamation within a wave-dominated bay in New Zealand. For this purpose, we first calibrated our morphological model based on the long-term evolution of the bay resulting from land reclamation carried out in the 1950s. This included the application of sedimentological spin-up and reduction techniques based on historical bathymetry datasets. The updated bathymetry, including the proposed modifications of the bay, was then used to predict the effect of the proposed land reclamation on the wave climate and morphology of the bay after one decade. We show that reshaping the bay induces a distinct symmetrical response of the shoreline which likely will modify the nearshore wave patterns and consequently recreational activities in the area.

Keywords: coastal waves, impact of land reclamation, long-term coastal evolution, morphodynamic modeling

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9841 Human Immune Response to Surgery: The Surrogate Prediction of Postoperative Outcomes

Authors: Husham Bayazed

Abstract:

Immune responses following surgical trauma play a pivotal role in predicting postoperative outcomes from healing and recovery to postoperative complications. Postoperative complications, including infections and protracted recovery, occur in a significant number of about 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on the healthcare system in any community. The accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain major clinical provocations. Recent Findings: Recent studies are focusing on immune dysregulation mechanisms that occur in response to surgical trauma as a key determinant of postoperative complications. Antecedent studies mainly were plunging into the detection of inflammatory plasma markers, which facilitate in providing important clues regarding their pathogenesis. However, recent Single-cell technologies, such as mass cytometry or single-cell RNA sequencing, have markedly enhanced our ability to understand the immunological basis of postoperative immunological trauma complications and to identify their prognostic biological signatures. Summary: The advent of proteomic technologies has significantly advanced our ability to predict the risk of postoperative complications. Multiomic modeling of patients' immune states holds promise for the discovery of preoperative predictive biomarkers and providing patients and surgeons with information to improve surgical outcomes. However, more studies are required to accurately predict the risk of postoperative complications in individual patients.

Keywords: immune dysregulation, postoperative complications, surgical trauma, flow cytometry

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9840 From Problem Space to Executional Architecture: The Development of a Simulator to Examine the Effect of Autonomy on Mainline Rail Capacity

Authors: Emily J. Morey, Kevin Galvin, Thomas Riley, R. Eddie Wilson

Abstract:

The key challenges faced by integrating autonomous rail operations into the existing mainline railway environment have been identified through the understanding and framing of the problem space and stakeholder analysis. This was achieved through the completion of the first four steps of Soft Systems Methodology, where the problem space has been expressed via conceptual models. Having identified these challenges, we investigated one of them, namely capacity, via the use of models and simulation. This paper examines the approach used to move from the conceptual models to a simulation which can determine whether the integration of autonomous trains can plausibly increase capacity. Within this approach, we developed an architecture and converted logical models into physical resource models and associated design features which were used to build a simulator. From this simulator, we are able to analyse mixtures of legacy-autonomous operations and produce fundamental diagrams and trajectory plots to describe the dynamic behaviour of mixed mainline railway operations.

Keywords: autonomy, executable architecture, modelling and simulation, railway capacity

Procedia PDF Downloads 81